Abstract 17952: Age-Dependent Disparities on Associations of Socioeconomic, Lifestyle, and Metabolic Risk Factors With Major Cardiovascular Diseases and Mortality

Abstract

Introduction: Existing studies that quantified and compared the relative risks (RRs) and population-attributable risks (PARs) of modifiable risk factors for cardiovascular diseases (CVDs) and mortality by age have been limited to conventional factors and moderate PARs. Methods: 335 540 participants from UK Biobank were stratified into <55 years (n=138 058), 55-65 years (n=140 224), and ≥65 years (n=57 258). The outcomes included incident CVD, coronary heart disease, heart failure (HF), ischaemic stroke, CVD mortality, and all-cause mortality. Results: The PARs for CVD cases and deaths were 11-24% for socioeconomic factors, 14-27% for lifestyle factors, and 34-41% for metabolic factors, which collectively measured 58-82%. Younger participants had significantly higher RRs of CVDs associated with socioeconomic, lifestyle, and metabolic risk factors (P interaction <0.05), and higher PARs from socioeconomic and lifestyle risk factors (Figure). For socioeconomic factors, area deprivation accounted for 10.5% of CVD deaths, while PARs of low education for CVDs and mortality ranged from 9.1% to 12.8%. Smoking accounted for 4.2-10.9% of PARs for CVDs and mortality, and other lifestyle factors such as unhealthy sleep (i.e. 5.6% for CVD mortality) and poor diet (i.e. 5.5% for IS) also contributed to moderate PARs. Metabolic risk factors accounted for 30.9% (28.6-33.2%) to 44.9% (39.0-50.7%) of CVD cases and deaths in all age groups, with hypertension being the predominant risk factor (22.4-32.5%). Conclusions: Socioeconomic and lifestyle risk factors showed stronger associations with CVDs and mortality among relatively younger people, while cases attributed to metabolic risk factors were consistently high in all age groups. This study further supports the role of an integrated CVD prevention strategy that combines social, behavioural, and medical approaches, especially among younger population.